AN EFFECTIVE PRACTITIONER

The evidence-based practice contributes to the effective personal development of healthcare practitioners (Greenhalgh, 2017). This essay is going to address how the in-depth understanding of different forms of literature contribute to informing their disciplines. This essay is going to present a critical analysis of the selected literature by using the CASP tool. Through presenting this critical analysis, this essay will demonstrate the strengths and weaknesses of the research paper thereby analysing how the evidence-based study helps practitioners to maintain personal development. Here the essay will also present a SWOT analysis of the healthcare practitioner thereby determining the developmental needs of the practitioner. Here the essay will discuss why the selected literature has been chosen and why the CASP tool is going to be used to make a critical analysis of the literature. In addition to this, the essay will address the benefits and limitations of the CASP tool while making a critical analysis of a research paper. The essay is going to present a clear critical analysis of the study design, methodology, research approach and research findings of the selected literature thereby describing the impacts of the critical analysis on the research article on practitioner’s personal development.

This essay has selected the qualitative research article “A Qualitative Evaluation of the Barriers and Facilitators Toward Implementation of the WHO Surgical Safety Checklist Across Hospitals in England” written by Russ et al. (2015), for presenting the critical analysis. This research paper aims to make a critical evaluation of how the WHO surgical safety checklist has been implemented by the healthcare practitioners in terms of assuring the patient's safety in the post-surgical environment. Here the research paper points out the lessons of implementation of the safety checklist that the operating department practitioners (ODP) must learn to ensure providing safe post-surgical care to patients. The selection of this research paper is justified and relevant based on the modern healthcare context. As mentioned by Ramsay et al. (2019), in England the rate of patient’s mortality and morbidity due to occurrence of post-surgical infection has been increased in recent times. A recent report from the WHO has mentioned that the reason behind the ever-increasing number of post-surgical deaths and morbidity of patients is due to the fact that the healthcare practitioners are less competent to implement the surgical safety checklist into the practices. As mentioned by Portugal et al. (2020), operating department practitioners (ODP) must have a clear knowledge of all the items mentioned on the WHO surgical checklist. Through implementing the checklist, ODPs can improve the information delivery system as well as communication in the operation ward that can improve the coordination among medical practitioners (Ramsay et al. 2019). However, in recent due to the lack of skill, competencies and expertise of the medical practitioners and ODP, there is increasing rates of death of patients in operating rooms as well as in the post-surgical environment across England. In this context, the selection of this research paper is highly justified and relevant that will provide a new insight on the importance of the personal development through evidence-based practice for the healthcare practitioners, especially for ODPs in term of providing the high quality and safe care to patients.

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While it comes to critique any research article researchers must ensure that the critical analysis tool that is going to be used is highly applicable to the type of the research study presented on the selected research paper (Dempsey et al. 2018). Here CASP (Critical Appraisal Skills Programme) is chosen to critique the selected paper. CASP tool is the critical appraisal tool that is used by the researcher to systematically evaluate the validity, trustworthiness, relevance and authenticity of any research paper. In the healthcare context, CASP also contributes to developing the competence level and professional knowledge of healthcare practitioners by assisting them to learn from the evidence-based practice. CASP tool has a highly useful checklist in which there are many options of critiquing different types of the research paper such as quantitative, cohort study, randomised trial and systematic review. Therefore before using the CASP checklist, it is important to have clear knowledge on the types of research study has been presented in the selected research paper here the selected research paper presents the qualitative research design in which longitudinal interview has been conducted for collecting the data (Majid and Vanstone, 2018). CASP is the only effective appraisal tool which assists the researcher to critique the particular types of research study by using the checklist questionnaires that are specifically made for that particular research type. In this context selection of the CASP tool for presenting a valid critical analysis of the selected research paper is highly justified and appropriate. While using the CASP tool, it is important to analyse the goal of the selected research paper that is going to be critically analysed (Galdas, 2017). Here the selected qualitative research aims to evaluate the ways the WHO surgical safety checklist has been implemented in the hospital’s situation England. The objectives of the research paper are to determines the potential facilitator and the barriers that are associated with the effective implementation of the WHO surgical checklist. The CASP tools are highly useful in this study to critically analyse the selected paper, because through using the checklist qualitative research study, it is possible to evaluate the research design, methodology, research approaches research findings and analysing of the selected article. CASP tool is to make the justified evaluation of whether the researchers of the selected research papers can meet the research objective after the accomplishment of the research study.

While using the CASP tool checklist for qualitative research, it is important to analyse whether the objective stance of a subjective stance is used in the research study of the selected paper. As mentioned by Majid and Vanstone (2018), in quantitative research generally the research study is based on the objective stance, in which all the statements that are presented in the research paper are based on the scientific facts and realistic observation. On the other hand, in case some secondary researchers, researcher sometimes use the subjective stances, especially while presenting any theories, in which the researchers present the perspectives, assumption and beliefs. In the selected research paper, researchers have successfully presented the subjective stance of the research study, in which the assumptions, perception, beliefs of the interviewee are presented. As argued by Hong and Pluye (2019) not only in the secondary research, in the primary research paper, researcher sometimes uses the subjective stance while they try to link any theory of specific models to their collected database. Although in the selected research paper, researchers have used the subjective stance in which the perspectives, beliefs and the personal opinion of the selected participants regarding the way of implementation of the WHO surgical safety checklist have been presented.

The second criteria of the CASP checklist for the qualitative research paper are clear aims and objectives mentioned the paper (Soilemezi and Linceviciute, 2018). The selected research paper mentioned the clear aim and objectives behind conducting the research study. In this section, the researchers have pointed out that the research study has the aims to evaluate how the WHO surgical safety checklist has been implemented in the hospital in England. The objectives of the research study are comprehensively discussed in the paper, which states that, through carrying out this research, researches want to provide a potential insight on the importance of learning the lesion of implementation of the WHO surgical checklists for the ODP and the medical assistants. In this context, LoBiondo-Wood and Haber (2017) argued that, while critiquing any research paper it is important to analyse that whether the aims and objectives that are set for the research study are relevant and realistic to the contemporary world. In this context, it can be stated that the aims and objectives presented in the selected research paper are highly realistic and relevant to contemporary healthcare issues. In recent years, due to the lack of skills, expertise and competency level of the medical practitioners and ODP, the death of patients in the operating rooms and the post-surgical condition has been increased. Evidence shows that the majority of the ODP lacks proper knowledge on the WHO surgical safety checklist, which enhance the risk of patient’s mortality due to post-surgical infection. In this context, the sims and objectives that are presented in t selected research study are highly realistic and relevant to the concurrent healthcare issues. Therefore, it can be stated that in the selected research paper researcher have selected such as and objectives that provided the new insight in the importance of the evidence-based practices and personal development of ODP and medical practitioners in terms of ensuring patients safety. Therefore, it can be stated that, that the selected research paper has successfully met the second checklist criteria df the CASP which present validity and authenticity of the research aim and objectives.

After critique the aim and objectives of the selected research paper, the next CASP checklist criteria is the research methodology. According to Squires and Dorsen (2018), while presenting any critical analysis of any research paper, the research method is one of the most important aspects that need to be evaluated. Through using the CASP checklist, it is possible to analyse whether the researcher has successfully presented the subjective experiences or objectives fact in the research study. As argued by Buccheri and Sharifi (2017), while critically analysing the research design of any paper, it is important to address that whether the research method used in the paper is right and appropriate to the types of research. The author also argued that while analysing any research study, it is not sufficient to just discuss the subjective or objective stance of the research method, rather there needs a crucial discussion on what the research study seeks to illuminate or interpret through presenting specific methods. On the other hand, Paulus and Lester (2021) mentioned that a good research design is that which has a comprehensive discussion on the reason behind choosing the methodology and how the methodology can assist researchers to meet research objects. Here in the selected qualitative research paper there although there is a method section, the lacks clear information on the types of research methods are used here and the reason for selecting the research method. On the other hand, the lack of mentioning of the proper methodology raises question o the authenticity, validity and credibility of the research methodology of the research paper. In this context, LoBiondo-Wood and Haber (2017) mentioned that a good research methodology must discuss what types of research method is used for the research study. There are many types methods are used while carrying out qualitative research such as semi-structured interview, case analysis, action research, ethnographic study and in-depth research. Although in the selected research it is not mentioned in the method section, from analysing the ensure research paper it is clear that here semi-structures interview has been carried out by the researchers to collect the valuable information from the selected 119 participants from 10 England based hospitals. In the method section, the research paper does not mention why this research method has been selected for this study. On the contrary, LoBiondo-Wood and Haber (2017) argued that not only the research methods and its reason for selection, but also the relevance and appropriateness of the research design to the contemporary practices need to be analysed during critical analysis. On this note, the selected research paper does not present any discussion regarding why the longitudinal or semi-structured interview is selected and why it is relevant to this study. This lack of information regarding the research methodology poses the question on the validity of authenticity and reliability of the research methods used in this selected research paper. Therefore, it can be stated that this research paper failed to meet the CASP tool checklist for the research method.

The next CASP checklist criteria are research design. As mentioned by Majid and Vanstone (2018), a good research design is something that presents the basic strategy of research by presenting the action plan that assists the research study to proceed towards the conclusion. In qualitative research, different types of research design are used by the researchers based on the needs and criteria of the research study. These are ethnographic design, historical research, narrative research, case study and phenomenology. On this note, the selected research although has a clear research design section here is no clear discussion regarding which kind of research design has been selected by the researcher and why. However, through evaluating the qualitative research paper, it is clear that here, the researcher has selected the phenomenology research design. In this context, Shelton et al. (2018) mentioned that phenomenology research design is based on presenting the particular phenomena of people during the specific condition. In a qualitative research design, the phenomenological research design is highly appropriate because it assists the researcher to present the personal opinion, beliefs and perspectives of the participants regarding the research topic. In the selected qualitative research paper, Russ et al. (2015) has presented IR (operating room) staff’s perception regarding the following of surgical safety checklist into practice to provide the safe and high-quality care to patients before, during and after the surgery. Through analysing the research design section of the selected qualitative paper, it is seen that here researcher has clearly described what the OR staffs think about the accidents due to the lack of competency of ODP and medical practitioners in implementing the WHO surgical safety checklist. On the contrary Melnyk et al. (2018) argued that good research design is not something that only mentioned that what types of design have been used by researchers, rather the good research design is something that presents a clear rationale of the selection of that particular type of design over the many other designs. However, in the qualitative research paper, Russ et al. (2015) does not present any kind of rationale behind the selection of t phenomenological design, which pose the question on the validity and trustworthiness of the research study. Therefore, it can be stated that this research paper does not meet the CASP checklist criteria for the research design.

Then the two most important CASP checklists are recruitment and the data collection process. As mentioned by Knaak et al. (2017), while critically analysing any research study, researchers must analyse why and how the particular recruitment process has been used in the study. By using the CASP checklist for the recruitment process, it is seen that the selected qualitative research paper has mentioned that the semi-structured interview has been carried out for this research study. Here in the selected research paper, Russ et al. (2015) have also mentioned the entire process of recruitment of the 119 OR staffs from the 10 English hospitals. As argued, Buccheri and Sharifi (2017) a good qualitative research paper must mention the recruitment criteria based on which the participants are selected. Here in the select qualitative paper, the selection criteria for the OR staffs are mentioned such as geographic spreads safety incident level and recruitment checklist. Additionally, this paper also has a clear discussion on the process of interview, in which it is mentioned that the telephonic interview has been carried out by a well-trained interviewer. In this context, Aarons et al. (2017) mentioned that a good qualitative research paper must have a clear and well-constructed data collection section, in which there is the detailed description on the process in which the data are collected from participants. The selected qualitative paper presents a clear discussion on the fat collection process, which mentioned that participants are asked the open-ended question over telephone. Here the research paper also mentioned that the open-ended questions are used to capture the detailed answer from participants. Although this research paper has discussed the detailed description of the recruitment and data collection process, it failed to present some important aspects such as consent, confidentiality, research ethics during eth data collection process which can pose the question on the validity and authenticity of the research.

As mentioned by Knaak et al. (2017), while critique any research paper, it is also important to analyse the ethical issues, potential bias and research limitations of issues. By using the CASP checklist it is seen that in the reselected research paper, Russ et al. (2015) do not mention the ethical issues, such as ethical approval, informed consent, participants autonomy, non-maleficence and transferability of the database. Additionally, the research paper does not address the research issues or limitations, that are important to be presented in any good research paper so that the future researchers will work on these limitations to overcome them. Also, the research paper does not mention whether there is any kind f bias or influence during the development of the research questions and also how the researches respond to research event throughout the study. All these drawbacks pose a big question on the reliability, trustworthiness and authenticity of the research paper.

This critical analysis is highly informative and knowledgeable for me. That assists me to understand the importance of the evidence-based practice for the medical practitioners (Knaak et al. 2017). being an operating department practitioner (ODP), I can link the knowledge and information that I gather through the above-mentioned critical analysis of the selected research paper. This evidence-based study has assisted me to improves my knowledge about the importance of the surgical safety checklist in providing safe care to the patient. This critical analysis encourages me to gather in-depth knowledge on the different items of the WHO surgical safety checklist that will assist me to maintain a safe and aseptic environment in the operating room thereby preventing chances of any infection to patients. The critical analysis of the research paper also assisted me to develop my understanding in determines my strength and weaknesses that will assist me to shape my skills as the ODP.

Through carrying out the SWOT analysis, I am, able to determine my strength, weakness, opportunities and threats. The ability to critique any research paper assist healthcare practitioners to be involved in the evidence base practices. Through carrying out the evidence-based practices I am able to determine my strength shish are my fluent and good communication skill, good listening skill, strong time management skill and good adaptability skill.

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Through carrying the critical analysis of the research paper, I am able to determine my weaknesses such as lack of quick decision-making skill, quick learning ability, poor surgical knowledge and poor knowledge on the surgical instruments. All these limitations need to be encountered by improving the professional knowledge and expertise (Shelton et al. 2018.).

My threats are job insecurity in the surgical field, due to my poor surgical knowledge. From the above-mentioned critical analysis, I understand that I need to improve my practical and theoretical knowledge of the operating process and surgery. I also find out that I need to improve my knowledge of different modern operating instruments.

From the abovementioned discussion, it can be concluded that evidence-based practice is highly important for healthcare practitioners that enhance their professional skill and promote their personal development. Critical analysis of literature assists healthcare practices to develop the habit of carrying out the evidence-based practice which will improve their knowledge, practical skill and abilities. Through evidence-based practice, healthcare practitioners can also determine their strength and limitations thereby can shape their professional skill to provide the best quality care to patients.

Reference list:

Aarons, G.A., Sklar, M., Mustanski, B., Benbow, N. and Brown, C.H., 2017. “Scaling-out” evidence-based interventions to new populations or new health care delivery systems. Implementation Science, 12(1), p.111.

Buccheri, R.K. and Sharifi, C., 2017. Critical appraisal tools and reporting guidelines for evidence‐based practice. Worldviews on Evidence‐Based Nursing, 14(6), pp.463-472.

Buccheri, R.K. and Sharifi, C., 2017. Critical appraisal tools and reporting guidelines for evidence‐based practice. Worldviews on Evidence‐Based Nursing, 14(6), pp.463-472.

Dempsey, R.C., McAlaney, J. and Bewick, B.M., 2018. A critical appraisal of the social norms approach as an interventional strategy for health-related behavior and attitude change. Frontiers in psychology, 9, p.2180.

Galdas, P., 2017. Revisiting bias in qualitative research: Reflections on its relationship with funding and impact.

Hong, Q.N. and Pluye, P., 2019. A conceptual framework for critical appraisal in systematic mixed studies reviews. Journal of Mixed Methods Research, 13(4), pp.446-460.

Hong, Q.N. and Pluye, P., 2019. A conceptual framework for critical appraisal in systematic mixed studies reviews. Journal of Mixed Methods Research, 13(4), pp.446-460.

Knaak, S., Mantler, E. and Szeto, A., 2017, March. Mental illness-related stigma in healthcare: Barriers to access and care and evidence-based solutions. In Healthcare management forum (Vol. 30, No. 2, pp. 111-116). Sage CA: Los Angeles, CA: SAGE Publications.

LoBiondo-Wood, G. and Haber, J., 2017. Nursing research-e-book: methods and critical appraisal for evidence-based practice. Elsevier Health Sciences.

Majid, U. and Vanstone, M., 2018. Appraising qualitative research for evidence syntheses: a compendium of quality appraisal tools. Qualitative health research, 28(13), pp.2115-2131.

Melnyk, B.M., Gallagher‐Ford, L., Zellefrow, C., Tucker, S., Thomas, B., Sinnott, L.T. and Tan, A., 2018. The first US study on nurses’ evidence‐based practice competencies indicates major deficits that threaten healthcare quality, safety, and patient outcomes. Worldviews on Evidence‐Based Nursing, 15(1), pp.16-25.

Patterson, J. and Dawson, C., 2017. Critical appraisal of qualitative literature. Perspectives of the ASHA Special Interest Groups, 2(13), pp.122-128.

Paulus, T.M. and Lester, J.N., 2021. Doing Qualitative Research in a Digital World. SAGE Publications, Incorporated.

Portugal, L.G., Adams, D.R., Baroody, F.M. and Agrawal, N., 2020. A surgical safety checklist for performing tracheotomy in patients with coronavirus disease 19. Otolaryngology–Head and Neck Surgery, 163(1), pp.42-46.

Ramsay, G., Haynes, A.B., Lipsitz, S.R., Solsky, I., Leitch, J., Gawande, A.A. and Kumar, M., 2019. Reducing surgical mortality in Scotland by use of the WHO Surgical Safety Checklist. British Journal of Surgery.

Russ, S.J., Sevdalis, N., Moorthy, K., Mayer, E.K., Rout, S., Caris, J., Mansell, J., Davies, R., Vincent, C. and Darzi, A., 2015. A qualitative evaluation of the barriers and facilitators toward implementation of the WHO surgical safety checklist across hospitals in England: lessons from the “Surgical Checklist Implementation Project”. Annals of surgery, 261(1), pp.81-91.

Shelton, R.C., Cooper, B.R. and Stirman, S.W., 2018. The sustainability of evidence-based interventions and practices in public health and health care. Annual review of public health, 39, pp.55-76.

Soilemezi, D. and Linceviciute, S., 2018. Synthesizing qualitative research: reflections and lessons learnt by two new reviewers. International Journal of Qualitative Methods, 17(1), p.1609406918768014.

Squires, A. and Dorsen, C., 2018. Qualitative research in nursing and health professions regulation. Journal of Nursing Regulation, 9(3), pp.15-26.

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